Q: Dr. Eppley, I’m interested in reducing scleral show and raising my lower eyelid, from what I’ve read from your articles the best solution is usually a combination of an infraorbital rim implant combined with a lateral canthopexy. I’ve included some pictures to show if you think this would address these issues.
A:You have correctly surmised that in the presence of infraorbital rim bony deficiency the placement of an infraorbital rim implant or a combined infraorbital rim-malar implant to build up the bone is needed to reduce scleral show. There is a linear relationship between the lower lid margin and the shape and height of the infraorbital bone…which is no an anatomic surprise.
Integrated into the placement of an infraorbital rim implant or infraorbital rim-malar implants are soft tissue procedures such as a cheek lift and lateral canthoplasty which when all combined help drive up the lower eyelids and reduce scleral show.
Dr. Barry Eppley